ROAD SAFETY
Highway Traffic Act strengthens
medical reporting requirements
I
n Ontario, physicians are required by law to
report patients who may be medically unfit to
drive. The Ministry of Transportation has clarified
the reporting obligation related to fitness to drive
by specifying the medical and visual conditions and
functional impairments that trigger a mandatory report.
The medical reporting requirements in the Highway
Traffic Act (HTA) have been strengthened to: enhance
road safety; clarify which conditions health-care
practitioners are required to report; and improve the
ministry’s ability to identify potentially unsafe drivers.
Effective July 1, 2018, it will be mandatory for
physicians, nurse practitioners and optometrists to
report certain high risk medical conditions, functional
impairments and visual impair-
ments. Health-care practitio-
ners are also permitted to make
discretionary reports for any
person who, in the opinion of
the health-care practitioner, has
or appears to have a medical
condition, functional impair-
ment or visual impairment that
may make it dangerous for the
person to drive.
As of July 1, the following are
prescribed medical conditions, functional impairments
and visual impairments that would trigger a manda-
tory report:
1. Cognitive impairment: a disorder resulting in cog-
nitive impairment that,
o affects attention, judgment and problem solv-
ing, planning and sequencing, memory, insight,
reaction time or visuospatial perception, and
o results in substantial limitation of the person’s
ability to perform activities of daily living.
2. Sudden incapacitation: a disorder that has a mod-
erate or high risk of sudden incapacitation, or that
has resulted in sudden incapacitation and that has a
moderate or high risk of recurrence.
3. Motor or sensory impairment: a condition or disor-
der resulting in severe motor impairment that affects
co-ordination, muscle strength and control, flexibil-
ity, motor planning, touch or positional sense.
4. Visual impairment: where prescribed regulatory
standards are not met.
5. Substance use disorder: a diagnosis of an uncon-
trolled substance use disorder, excluding caffeine
and nicotine, and the person is non-compliant with
treatment recommendations.
6. Psychiatric illness: a condition or disorder that
currently involves acute psychosis or severe ab-
normalities of perception such as those present
in schizophrenia or in other psychotic disorders,
bipolar disorders, trauma or stressor-related disor-
ders, dissociative disorders or
neurocognitive disorders, or
the person has a suicidal plan
involving a vehicle or an intent
to use a vehicle to harm others.
Physicians and other health-
care practitioners are not
required to report if it is their
opinion that the impairment is
of a distinctly transient or non-
recurrent nature.
There is also an exception related to aging: reporting
is not required where there are incremental changes in
ability that, in the opinion of the health-care practi-
tioner, are attributable to a process of natural aging,
unless the cumulative effect of the changes constitutes
a condition or impairment described above.
A new medical reporting form for use by physi-
cians, nurse practitioners and occupational therapists
will be used for both mandatory and discretionary re-
ports. The form has been approved by the Ministry of
Health and Long Term Care and the Ontario Medi-
cal Association, and will be available on the Ministry
of Transportation’s website as of July 1, 2018.
The reporting obligation can be found in Ontario
Regulation 340/94, s. 14.1(3). In the event of ques-
tions, please ob tain independent legal advice.
MD
ISSUE 2, 2018 DIALOGUE
29